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4/20/2001

Canadian Pharmacist Services Cut Employer Expenses

Kate Traynor

A Canadian study shows that patients who use the disease management expertise of community pharmacists spend more time working and less time visiting a physician or a hospital emergency room than patients who do not use this service.

Compliance with drug therapy improved when patients consulted their pharmacist regularly about managing asthma, gastroesophageal reflux disease, or peptic ulcer disease, the study found. Despite an increase in the number of prescriptions filled for study participants, annual drug costs—about 7500 U.S. dollars—were the same for these patients and a matched control group.

Data collected by the Canadian government revealed that the 262 patients involved in the intervention were more productive at work, saving their employers an estimated $7000 through the year, compared with the controls. An additional annual saving of $4500 was attributed to the employees, who were all civil servants, or their dependents spending less time at home sick or at a physician’s office or laboratory.

"It’s very well recognized that pharmacists can provide very beneficial services to patients," said Deb Saltmarche, director of pharmacy for the Canadian Association of Chain Drug Stores (CACDS), which cosponsored the study. But until now, she noted, "it hasn’t been well documented in terms of quantitative savings to the health care system."

The project, dubbed the Fredericton Pharmacy Initiative, involved all 21 community pharmacies in the New Brunswick capital city and the neighboring town of Oromocto. About a quarter of the patients who were expected to be eligible for the program participated in the study.

Saltmarche said the pharmacists in the program provided their customary patient-counseling services. In general, she said, patients in Canada expect their community pharmacists to provide counseling on all new prescriptions.

As each patient entered the program, Saltmarche said, the pharmacist would counsel him or her about the prescription, set up a time for a follow-up interview, and then discuss the disease and medication use. The pharmacist would also assess the patient. Through this process, the pharmacists "were documenting their interventions so that we could track the effects of the interventions on the health and wellness of the patient," Saltmarche said.

Nurses interviewed the patients at baseline and every three months after the program started. During the interviews, Saltmarche said, patients were asked about their general health status, satisfaction with the pharmacist’s services, and compliance with drug therapy. Prescription-use data came from the employees’ health plan, and hospitalization data came from the New Brunswick Department of Health and Wellness.

More than half of the study participants reported feeling better after 12 months. About 65% of the asthma patients and 80% of those with gastrointestinal disorders said that they understood their condition better after participating in the study. Almost all patients reported liking the intervention program.

Saltmarche said she hopes that the definitive cost-savings data can help Canadian pharmacists expand their role as health care providers.

"Pharmacists have been recognized as one of the most underutilized health care resources within the primary health team," Saltmarche said. "In many cases, they’re not recognized or involved in discussion involving primary health care."

Funding for the Fredericton Pharmacy Initiative was provided by the New Brunswick Department of Health and Wellness. CACDS reported the study’s findings in February at the organization’s third annual Chain Drug Conference in Toronto.